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Missouri rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,444.31 / $2,136.37 / $2,204.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,444.31 / $1,654.93 / $3,008.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,161.29 / $3,319.35 / $14,592.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,673.02 / $1,696.36 / $2,557.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $1,743.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,272.44 / $1,272.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,444.31 / $2,547.75 / $14,630.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,159.73 / $1,689.84 / $2,909.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,159.73 / $1,577.14 / $2,203.48